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Lymphocyte CountAka: Lymphocyte, B-Lymphocyte, T-Lymphocyte, Natural Killer Cell, Lymphocytosis

Characteristics
1. Function: Primary source of viral defense and antibody
  1. Lymphocyte Sub-Classes
    1. B-Lymphocytes
      1. Differentiate into plasma cells
      2. Plasma cells release specific antibodies
    2. T-Lymphocytes
      1. Response to viral infection, cancer, foreign cell
    3. Natural Killer Cells (NK Cells)
      1. Attack cancer cells and cells infected with virus
2. Morphology on Blood Smear
  1. Mononuclear Leukocytes (same class as Monocytes)
  2. Small cells with minimal cytoplasm
Normal
1. Percentage Lymphocytes: 15-40% of White Blood Cells
2. Total Lymphocytes: 800-2600/mm�
3. Total T Lymphocytes: 800-2200/mm�
  1. T helper Cells: >400/mm�
  2. T suppressor Cells: 250-750/mm�
  3. Helper Cell to Suppressor Cell ratio: >0.9
  4. CD2 Percentage of Lymphocytes: 65-85%
  5. CD4 Percentage of Lymphocytes: 45-75%
Increased (Lymphocytosis)
1. Increased Absolute Lymphocyte Count (>4500/mm3)
  1. Non-activated Lymphocytes
    1. Influenza
    2. Pertussis
    3. Tuberculosis
    4. Mumps
    5. Varicella
    6. Herpes Simplex Virus
    7. Rubeola
    8. Brucellosis
    9. Chronic Lymphocytic Leukemia
    10. Acute Lymphoblastic Leukemia
  2. Activated Lymphocytes (Atypical lymphocytes)
    1. Cytomegalovirus Infection
    2. Infectious Mononucleosis
    3. Infectious Hepatitis
    4. Toxoplasmosis
    5. Post-transfusion
    6. Medication
      1. Mephenytoin
      2. Dilantin
      3. Para-aminosalicylic acid
2. Increased Relative Lymphocyte Count
  1. Normal finding in children under age 2 years
  2. Acute stage of viral infection
  3. Connective tissue disease
  4. Hyperthyroidism
  5. Addison's Disease
  6. Splenomegaly
Decreased
1. AIDS
2. Bone Marrow suppression
3. Aplastic Anemia
4. Neoplasms
5. Steroids
6. Adrenocortical hyperfunction
7. Neurologic Disorders
  1. Multiple Sclerosis
  2. Myasthenia Gravis
  3. Gullain Barre Syndrome

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This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.